On Tuesday, doctors and officials from the United Nations’ refugee agency, UNHCR, will meet with senior staff from the immigration department. They will discuss the findings of the agency’s inspections of offshore detention camps on Nauru and Manus Island, and their physical and psychological examinations of their occupants, which have yet to be made public. These trips were conducted in April and May this year, and draft reports were written in June. The Saturday Paper has acquired both reports, and they offer perhaps the clearest picture yet of the camps’ disturbing structural, legal and procedural inadequacies.

The Saturday Paper understands the final reports have only recently been provided to the governments of Australia, Papua New Guinea and Nauru. Geneva was concerned providing the reports earlier, just before federal elections – Nauru’s was held a week after our own – might be perceived as political mischief. However, interim reports – which make urgent recommendations – were quietly provided to the Australian government months ago and, an author tells me, subsequently ignored. “Even though rates of mental disorder are extraordinary,” Dr Nina Zimmerman tells me, “they didn’t listen.” Zimmerman is a forensic psychiatrist with extensive experience in custodial settings and was invited by the UNHCR to conduct examinations in Nauru. “So they have been notified, but were dismissive.”

“Eighty-eight per cent of asylum-seekers were suffering from a depressive or anxiety disorder and/or PTSD ... among the highest recorded of any population in the world.”

Zimmerman now risks opprobrium. But she has come forward because, she says, she has a duty of care that’s being frustrated by Geneva’s timidity and the Australian government’s indifference. She fears the reports will never be made public, much less acted upon. In her personal notes from a teleconference in June, she has written: “Geneva uncomfortable with the idea of a public release of the report.”

The UNHCR made a similar reporting mission in October 2013 and released its reports the following month. What’s useful now, though, is that with the two reporting missions – conducted at the beginning of the renewed offshore policy, and again three years later – we have a rough cross-sectional study of those subject to mandatory, indefinite detention.

One of the most damning aspects of the draft report on Manus Island is how clearly it shows that detention itself has contributed to endemic mental disorders. “Eighty-eight per cent of asylum-seekers and refugees assessed were suffering from a depressive or anxiety disorder and/or post-traumatic stress disorder,” the draft report says. “These are extremely high rates, among the highest recorded of any population in the world, but a predictable outcome of protracted detention.

“The vast majority of asylum-seekers and refugees surveyed were asymptomatic prior to arrival on Manus Island. The observed symptomatology is therefore likely to be directly attributable to the effects of prolonged indefinite mandatory detention, and to the violent incidents that most asylum-seekers and refugees witnessed and/or were directly involved in at the Lombrum Regional Processing Centre in early 2014 and 2015.”

One of those “violent incidents” was the 2014 riot in which Iranian man Reza Barati was bludgeoned to death. Detainees I spoke with this week, who were friends of Barati’s, remain pained by his death and struggle to discuss it. “He was one of my close friends,” a detainee tells me of Barati. “He looked like one of Iranian actor and he was very kind with me. I never forget him. I am still have nightmares about the attack.”

UNHCR’s reports are similarly bleak about the mental health of those on Nauru. “It appears that PTSD and depression have reached epidemic proportions,” the report states. “UNHCR anticipates that mental illness, distress and suicide will continue to escalate in the immediate and foreseeable future.”

The Australian government called a stop to Zimmerman’s assessments on Nauru after the violent suicide of Omid Masoumali led to significant unrest. Zimmerman was just metres from Masoumali when he splashed himself with petrol and set himself alight. “We were conducting surveys at the time,” Zimmerman tells me of the moment. “We were set up in this portable place. That’s where I did my interviews. I had interviewed Omid’s wife only minutes before. She was very angry. Then I was sitting there talking to a Tamil woman – I could hear some shouting and chaos outside – and I kept trying to engage the woman and keep her calm. Then there was a terrible scream. I looked up as he went up in flames. There was a terrible smell. My translator ran to him to try and remove his clothes, another poured a bucket of water on him. His body was white, which indicates a full thickness burn.”

Zimmerman had conducted more than 50 clinical interviews before her mission was ceased, and she had determined – if Masoumali’s death hadn’t already confirmed it – that the refugees on Nauru were in crisis. She noted that this was a place where babies learn to crawl on phosphate rubble.

The draft report on the physical conditions of the Manus camps are similarly alarming. Inspectors found unusable toilets, broken washing machines, dilapidated gym equipment and serious overcrowding. They observed “conditions at the Lombrum Regional Processing Centre that are the equivalent to a maximum security prison in Australia, yet without appropriate safeguards in place… The dwellings in Delta and Oscar compounds currently provide approximately 1.68m2 per person, which is half the minimum international standard for prisons. The risks to public health and mental health of such overcrowding are considerable.”

Blatant indifference

The report records the indifference of Broadspectrum and Wilson staff to allegations of sexual assault, and argues that the reporting protocol deviates alarmingly from those applied to Australian prisons. “Staff members simply brushed off allegations of rape as unsubstantiated and did not appreciate the serious welfare concerns for victims. This is highly concerning.”

If the dilapidated gym equipment appears trivial amid these other conditions, the report wonders if its sorry state is contributing to an “extremely high rate” of musculoskeletal disorders – serially dislocated shoulders, trapped nerves, unstable knees – among detainees. Twenty-eight per cent of the men, a far higher number than would be expected in male Australian prison populations, presented with one of these. It is recognised that some of these injuries were caused by torture prior to their detainment; but some have been the result of the gym equipment itself. The report also recognises there are mental health consequences: “There is an urgent need for a professional audit of the quality of the gym equipment and to rectify it, recognising that for many people this is their only treatment recourse for depression.”

The comparison of the Manus camps with a poorly run maximum-security prison is alarming itself. The men on Manus have committed no crimes, and the UNHCR reports on the disturbing process of institutionalisation. The report’s authors “observed excessive levels of security at the Lombrum Regional Processing Centre that has created an institutionalised and punitive environment that is wholly inappropriate for asylum-seekers and refugees. Such an environment further compounds existing mental health issues identified by UNHCR’s expert medical professionals, particularly with the high numbers of security guards, the security checks undertaken each time a compound is left (daily for some who require medication) and referring to asylum-seekers and refugees by boat numbers rather than their names.”

Detainees I spoke to this week described themselves either as degraded prisoners or “zoo animals”.

The reports are equally damning about the processing of asylum claims, and the absence of durable settlement plans once applicants have been verified as refugees. Regarding the asylum procedures, the UNHCR reports that the process on Manus was sufficiently compromised that there’s a “very real risk that a number of asylum-seekers have wrongly been denied refugee status and in turn risk being refouled by Australia and Papua New Guinea to their home country”.

There follows the question of resettlement. Six of seven resettled refugees have been placed in the town of Lae in Papua New Guinea, which, with a homicide rate of 66 per 100,000, is among the 10 most dangerous cities in the world. In February this year, almost a hundred prisoners broke free of the local jail – a third of them died in subsequent gun battles with police. Unsurprisingly, the report notes, three of the seven men have since returned to Manus Island voluntarily.

There are also vastly inadequate resources offered to refugees for resettlement, an attempt, perhaps, to mollify locals’ jealousy. Instead, refugees are cut adrift from Papua New Guinean society – untouched by the help of family, clan membership, land entitlements, language – but placed among a population that largely resents their presence.

The UNHCR found similar levels of local resentment on Nauru, a poor and homogenous society, fearful that the proportionately large influx of refugees will diminish cultural purity and economic opportunity. Locals are also aggrieved that refugees serially denigrate their country in the international press, and the UNHCR report makes clear the toxic distrust between refugees and civic society. The result is refugees living in effective ghettos, under constant threat of vigilante violence.

The UNHCR’s advice – which we can only assume will be reinforced on Tuesday – is clear. That “Australia accept all transferred refugees and others with international protections needs or, at a minimum, those with family links to Australia… Alternatively, and as a lesser preferred option, the Governments of Australia and Papua New Guinea should seek to secure an alternate third country that complies [with UNHCR’s stated principles].”

Consistent with Zimmerman’s frustrations, such recommendations have been issued before in vain.

Fleeing Iran

“I am Arab from Ahvaz city,” Mehdi Savari tells me. “I fled alone. I had to leave my family. I had to risk my life in dangerous ocean. I didn’t have any other option. If I wanted to live, I had to risk my life. You have no idea what it’s like to be in that ocean. We were sinking in ocean and our boat engine was broken down, we were on small boat for three days and Australian Navy rescued us. I wouldn’t have thought I am going to suffer worse than the ocean. I wish I would have died in ocean.”

Mehdi stands just one metre tall. He’s been in the Manus compound for almost three years. Because of his height, he can’t reach the shower taps. He needs assistance with the toilets. He can’t sit on chairs and is prevented by security staff from playing sport in the yard. He tells me there are no modified utilities for him. He is greatly dependent on fellow detainees, men whose ability to help him has declined commensurately with their mental health.

Mehdi was an actor and comedian in Ahvaz. He hosted a satirical children’s show – clips show a dazzlingly coloured set, a wry smile upon its host’s face – where Mehdi says he poked fun at the Iranian government’s intolerance of free speech. Mehdi tells me this attracted its scorn, and he began to be harassed. Mehdi says he was already used to abuse because of his height. He fled, and ended up in Manus – where he has been adjudicated a refugee.

Other detainees tell me Mehdi was beloved for cheerfully putting on shows – monologues, comic sets or impressions. In turn, many men offered help and protection to their new friend. But times have changed with the years. Mehdi doesn’t have the energy or optimism for such displays and, even if he did, the others are no longer interested.

“Nobody stands these things anymore,” he tells me. “In early days I had many supports by my friends … but nowadays everybody is dealing with their own issues, just few are helping me. Everybody is mentally sick.”

Two weeks ago, Mehdi wrote to the Australian Border Force requesting special assistance. He tells me he had not received a satisfying response from his case manager in the camp. Mehdi wrote, in part: “I cannot use facilities and any other activity. I cannot play any sport because others do not let me to play. When I go to Lorengau [township] many local people humiliate me and they staring at me and laughing together. Everybody calls me lik-lik man. I did not know its meaning. I found it out later which means a dwarf. I hate myself because of it … I have been through many bad experiences and difficulties in the past three years. I would like to request both Australia and PNG governments to address my issues and help. I am human like you.”

In a clinically brief response, which begins with a misspelling of Mehdi’s name, Border Force refers him back to Broadspectrum, the company running the camp. Mehdi says he’s had no luck there, either. In addition to his dwarfism, Mehdi suffers deteriorating eyesight and a gastric ulcer. He is also deeply affected by the riots of 2014, which claimed the life of his close friend Barati.

These reports – which are now in the hands of our government – are further evidence of the dangerous conditions of our offshore camps, and the absence of durable settlement policies. Let it never be said that we didn’t know.

Lifeline 13 11 14

This article was first published in the print edition of The Saturday Paper on
Oct 8, 2016 as "Leaked UN report: Manus world’s worst ".
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